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Supply Decrease/Breast Injury

My LO is 4.5 mos. and I am working full time. I went back to work when she was 3 mos and I pump 3x a day and BF the rest of the time. She gets 3 -4 oz. bottles when I'm at work and she nurses every 2 hrs. in the evenings and on weekends. She wakes every 3-4 hours to eat overnight. Last week I had terrible nipple pain on the R side. She was being especially rough and holding my nipple in her mouth and stretching back the whole time she ate. This side has ALWAYS been a problem and no one knows why. We've see a LC (twice) and they said it looked like a bad habit. I think that side doesn't produce/flow as well and she has to pull, tug, and yank to get the same flow she's used to on the left. Sat, after a feeding she spit up blood and later in the day when I was pumping (to allow it to heal a little and give my poor nip a break), I realized that the beginning of my pumping was all blood. Sat night I was very engorged- no heat or fever. I could only get about one ounce out with the pump and the milk looked thinner than usual. Sun morning, I pumped again and still had the blood. *SIDENOTE* the blood was def not from my nipple but from inside the breast. Sun she went back to nursing as we were at church and I didn't have a choice and all blockages cleared up and did not have any more bleeding. In retrospect, she had black diapers from Friday-Sun and I realized I must have been bleeding for a few days.
That was all background info.
Now I'm all healed and it's not painful when she nurses but I am not pumping nearly as much and when I am with her, she wants to nurse ever 1.5 hr-ish. Is is possible that the problems I had over the weekend wrecked my supply? I desperately want BFing to go well but it seems as though we're always jumping hurdles with it. Is there something (besides nursing as much as possible) I should be doing? I have no milk in reserves and she hates/refuses formula so I'm very stressed. I had to take personal time from work yesterday because I knew there wasn't enough milk for her to have while I was gone.

Re: Supply Decrease/Breast Injury

Welcome to the forum!

Sorry you had such a rough time. The good news is that it sounds like you got through the worst of it, and at this point everything you're exeperiencing is in the normal realm, and is not an indication of poor supply.

Here's what I think happened: your baby was nursing roughly and caused some trauma to the breast. There was some bleeding in the breast, and that bleeding temporarily caused some plugged ducts. You got engorged, and that engorgement resulted in lowered supply in the damaged breast. Your body "reads" a full or engorged breast as reduced demand from the baby, and consequently reduces supply on that side. Luckily, you eventually cleared the plugs by nursing, which is, BTW, what you should do if this situation ever arises again. Babies empty the breast far better than the pump, and bloody milk looks gross but won't hurt the baby. It actually does not take much blood to tint your milk a truly shocking color.

A this point, the best thing you can do is to nurse on demand. Your body will match supply to demand, so as long as you allow your baby unrestricted demand, your supply will be fine. When you're at work, you kind of have to play it by ear. If you can get all the milk you need with the pump, great! If not, you need to use the pump to minic the demand a baby would give, which means pumping more frequently or perhaps adding in pump sessions after nursing when you're home with your baby.

It sounds like you're doing just great! I know it's hard to nurse through a bad episode like you experienced, but you didn't give up. That's awesome!

Re: Supply Decrease/Breast Injury

That really puts my mind at ease. The sight of blood really throws you. I love nursing her (even though it's rough sometimes) and really look forward to it as she gets older. Because she is my first baby, I had no idea what to expect and this website (and the mommies on it) have been SO helpful to me. Thank you so much!